Bone Conduction Devices Tied to Better Hearing-Related Quality of Life

By Lisa Rapaport

November 19, 2021

(Reuters Health) - People with single-sided sensorineural deafness who receive bone conduction devices experience improved hearing-related quality of life, but no change in general quality of life, a recent systematic review and meta-analysis suggests.

Researchers examined data from 11 studies with 203 adult participants who all had single-sided sensorineural deafness and underwent quality of life assessments before and after unilateral bone conduction device insertion.

The primary endpoint of the analysis was mean change in quality of life (QoL) scores six months after insertion of bone conduction devices. Quality of life assessments included the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial and Qualities of Hearing Scale (SSQ). Generic QoL was measured with the Health Utilities Index–3 (HUI-3).

Six months after bone conduction device insertion, researchers found a statistically and clinically significant improvement in both the global APHAB scores (mean change, 15.50). On the SSQ scores, researchers also found clinically and statistically significant changes on subscales for hearing qualities (mean change, 1.19), speech (mean change, 2.03), and spatial hearing (mean change, 1.51).

However, there was no significant change at six months in mean HUI-3 scores (mean change, 0.03).

"Although Bone conduction devices are an established form of treatment for conductive hearing losses or single-sided sensorineural deafness, studies exploring the individual non-hearing benefits of bone conduction devices in single-sided sensorineural deafness haven't shown improvement," said lead study author Thomas Hampton of the University of Liverpool in the UK.

Many previous studies evaluating the association of bone conduction devices with overall QoL in patients with unilateral and bilateral hearing loss looked at unvalidated measures, showed only modest benefits, or were underpowered, Hampton said by email.

"So not all clinicians agree on whether they provide patients with a meaningful QoL benefit," Hampton said.

There are several limitations to this meta-analysis, including the heterogeneity of QoL measures in the included studies as well as the lack of data on QoL at multiple points in time, the authors note in JAMA Otolaryngology-Head & Neck Surgery.

However, the results suggest that clinicians should look beyond general QoL and focus instead on hearing-related QoL when assessing the effectiveness of bone conduction devices for people with single-sided sensorineural hearing loss, the study team concludes.

"The real take-home is that improving quality of life is a good reason to recommend bone conduction devices to patients with single-sided sensorineural hearing loss," Hampton said. "But clinicians and academics need to measure both hearing specific quality of life measures as well as generic measures because previously when using only generic quality of life tools, we may have been under appreciating the meaningful benefit patients receive from the devices."

SOURCE: JAMA Otolaryngology-Head & Neck Surgery, online October 14, 2021.